| |
| GAC's 24
Hour Accident Limited Benefit Coverage |
|
|
Accident Coverage for Members and their Families |
|
| |
| • Helps pay
your medical expenses for hospital emergency room
and confinement, doctor and surgeon, lab test and
x-rays, and ambulance |
| • Accidental Death and
Dismemberment benefits up to $15,000 |
|
| |
| • Automatic acceptance through age
64 |
| • Benefits are
paid directly to you |
| • You can choose any doctor or
hospital |
| • Choice of plan options: $7,500,
$5,000 or $2,000 |
|
|
| |
| SCHEDULE
OF BENEFITS |
|
| Maximums Per Accident
Per Insured Member |
Option 1
|
Option 2
|
Option 3 |
| Accidental
Death & Dismemberment * |
$2,500 |
$10,000 |
$15,000 |
| Maximum
Medical Expense Benefit Paid Per Covered Accident |
$2,000 |
$5,000 |
$7,500 |
| Deductible
Per Accident |
$0 |
$100 |
$250 |
| Hospital
Confinement (Inpatient) |
$500 |
$1,250 |
$1,875 |
| Physician’s
Services (No Surgery) |
$500 |
$1,250 |
$1,875 |
| Surgery
(Includes Assistant Surgeon & Anesthesiologist Services) |
$500 |
$1,250 |
$1,875 |
| Laboratory
Expenses |
$200 |
$500 |
$750 |
| Ambulance
Services |
$200 |
$500 |
$750 |
| X-Ray
& Imaging Expenses |
$100 |
$250 |
$375 |
| Emergency
Room Services (Up to 3 visits per calendar year) |
$100 |
$150 |
$175 |
| Monthly
Cost - Single or Family ** |
$19.95 |
$29.95 |
$34.95 |
|
|
| * Accidental Death &
Dismemberment benefit for spouse and dependents are lower than amounts
shown. |
| ** Includes a $5.95 monthly
administration fee. |
| |
VALUE
BENEFITS OF AMERICA MEMBERSHIP
ALSO INCLUDES DISCOUNTS AND DIVIDENDS * |
|
| The
Dividend Club: Members
will earn Dividends (paid quarterly to you) on Merchandise, Services,
Travel & Entertainment when you shop from our On-line Mall and
make a purchase. Choose from retailers like these, just to name a few,
and get the dividends: Walmart.com, Target.com, BestBuy.com,
CircuitCity.com, CompUSA.com, DisneyStore.com, OfficeMax.com,
BrooksBrothers.com, Brookstone.com, Buy.com, EddieBauer.com,
LizClairborne.com, FOA.com, FOSSIL.com, HotelDiscounts.com, Jcrew.com,
etc. |
|
| Refund
Sweepers:
Free Merchandise, Bargains, On-line Coupons, Rebates, Sweepstakes
& more |
|
| Car
Rental Services: Provides
discounts at Alamo, National, Hertz and Avis |
|
| Rewards
Network: America’s
Premier Dining Rewards Program and Hotel Discounts. Save up to 20% off
every meal plus up to 15% off your hotel room rate |
|
| Included
at no charge: discounts
at over 55,000 pharmacies for your prescription drugs as well as lab
tests and x-ray imaging services |
| |
| Discount
Benefits Are Not Insurance |
| |
|
